Radiotherapy Department, Abderrahman Mami Hospital, Ariana, Tunisia.
Hematology Department, Military Hospital, Tunis, Tunisia.
Perm J. 2020 Nov;24:1-6. doi: 10.7812/TPP/19.156.
Mantle cell lymphoma is an aggressive disease. Limited treatment options are available for refractory or relapsing presentation. We report the first case, to the best of our knowledge, of concurrent radiotherapy and lenalidomide use in this setting, focusing on its possible synergy and tolerance.
A 76-year-old man with a history of mantle cell lymphoma presented with ptosis of the left eyelid, eyelid swelling, and nasal obstruction. Results of positron emission tomography-computed tomography revealed a pathologic fluorodeoxyglucose uptake at the pharynx and left eyelid. He received treatment with ibrutinib, which was stopped 3 months later because of digestive toxic effects. Radiotherapy for the eyelid and pharynx was performed at a dose of 18 Gy, with concurrent lenalidomide administration. Evaluation 3 months later revealed complete disappearance of the 2 relapse sites.
This case highlights the role of concomitant lenalidomide treatment and low-dose radiotherapy in patients with relapsing mantle cell lymphoma. Use of this combination treatment has achieved a complete local control with a safe toxicity profile. The case also illustrates the possible lenalidomide-induced radio sensitization.
套细胞淋巴瘤是一种侵袭性疾病。对于难治性或复发性表现，可用的治疗选择有限。我们报告了首例在这种情况下同时使用放疗和来那度胺的病例，重点关注其可能的协同作用和耐受性。
一名 76 岁男性，有套细胞淋巴瘤病史，表现为左眼眼睑下垂、眼睑肿胀和鼻塞。正电子发射断层扫描-计算机断层扫描结果显示咽和左眼眼睑存在病理性氟脱氧葡萄糖摄取。他接受了伊布替尼治疗，但 3 个月后因消化道毒性作用而停药。对眼睑和咽进行了 18 Gy 的放疗，并同时给予来那度胺治疗。3 个月后的评估显示 2 个复发部位完全消失。
该病例强调了在复发性套细胞淋巴瘤患者中同时使用来那度胺治疗和低剂量放疗的作用。这种联合治疗方案实现了完全的局部控制，且毒性谱安全。该病例还说明了来那度胺可能具有放射增敏作用。
